Vascular Surgery Patients Satisfied with Post-Surgical Telemonitoring

Patients who underwent telemonitoring following vascular surgery reported high satisfaction rates, and patient outcomes matched those who received traditional follow-up care, according to a new study.

Albeir Y. Mousa, M.D., a vascular surgeon and professor at West Virginia University’s Robert C. Byrd Health Sciences Center, told Healthcare Analytics News™ that he and colleagues wanted to show that telemedicine could be effective for post-operative monitoring.

The Appalachian Mountains run through West Virginia, and many patients live in rural communities far away from the medical center. “We’re sitting in a very geographically challenging area of the United States in West Virginia,” he added. Post-surgical patients often travel hours to get to follow-up appointments and then sit in waiting rooms for a checkup that might take only a few minutes.

In search of a better solution, Mousa and colleagues enrolled 30 participants who were undergoing vascular surgery in a study. Sixteen of the patients received a tablet equipped with the Telehealth Electronic Monitoring (THEM) app. The remaining patients received the standard, in-person follow-up.

The question was whether outcomes would differ depending on the method of follow-up.

The patients with tablets used the app every day to collect health data, including weight, pulse, blood pressure and temperature. They also took surveys about how they felt and photographed the surgical incision point in their groins. Meanwhile, care managers monitored the data and received notifications when red flags arose. If necessary, the care managers could have sought further information, called in a prescription or scheduled an in-person follow-up.

After 30 days, outcomes — measured by hospital readmissions and infection rates — were not statistically different between the telemedicine group and the control group. However, patients who used the app had higher quality-of-life scores and reported higher care satisfaction. The vast majority, 91 percent, of patients who used the app gave it a “4” or “5” on a scale of 1-5 when asked about its ease of use.

Mousa said he was pleased with the clinical results, which confirmed his belief that telemedicine will have a major role to play in the future of post-surgical healthcare. However, he said he was also heartened by the response patients had to the technology itself.

“I was surprised to see such a strong positive response, even with people who may not be computer users,” he said. “...They felt like we were not far away from them. They felt more secure and more confident that someone is looking after them.”

Mousa said some patients needed significant upfront training to use the tablet and app. But as patients grew comfortable with the technology, they also grew more satisfied.

Mousa’s next step is a second-phase study with a larger patient pool, which could definitively show that electronic follow-up matches or exceeds outcomes of patients who receive traditional follow-up care.

But while Mousa is optimistic about the technology, he said there is one major hurdle that still must be overcome: reimbursement. Currently, he can’t bill for the time performing this kind of remote monitoring of post-surgical patients. He says the Centers for Medicare & Medicaid Services and private insurers need to be on board with the telemonitoring program for the full benefits of follow-up telemonitoring to be realized.

“They have to reimburse the hospital for the time and the effort and technology,” he said. “There has to be some kind of fee.”

Mousa’s study, “Results of Telehealth Electronic Monitoring for Post Discharge Complications and Surgical Site Infections following Arterial Revascularization with Groin Incision,” was published in the Annals of Vascular Surgery.

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